Provider Demographics
NPI:1174803944
Name:JAYARAM, ANUPAM (MD)
Entity type:Individual
Prefix:DR
First Name:ANUPAM
Middle Name:
Last Name:JAYARAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1225 CRANE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4257
Mailing Address - Country:US
Mailing Address - Phone:650-324-0056
Mailing Address - Fax:650-324-1156
Practice Address - Street 1:1225 CRANE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4257
Practice Address - Country:US
Practice Address - Phone:650-324-0056
Practice Address - Fax:650-324-1156
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2016-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA144949207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery